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ELECTRICAL PERMIT APPLICATION <br />CITY OF EVERETT PERMIT SERVICES <br />3200 CEDAR STREET, EVERETT, WA 9820'I <br />425-257-8810 - FAX 425-257-8857 - www.evereriwa.org <br />APPLICATIONS ARE ACCEPTED FROM 8 AM TO 4 PM - DEBIT 8 CREDIT (; AROS ARE NOT ACCEPTED <br />�.�/v i �i %�U.S-�L C.�/�C,�r /%U � <br />PRC�JECT ADDRESS <br />f�l x G��� c..el� �'D�/y i�c�u�c�ct �IuS t�c.�D'� w•�- <br />Owner Mail Address City State/Zip Phone <br />Tenant <br />Mail Address <br />Cfty <br />State2ip <br />Phone <br />D-5� � l�� f- :� :to/l 7.�'rS.- £ C�e.ed ui-� 9�10� <br />Electrical Contractor Mai1 Address Ciry Stale2ip Phone <br />(�.S�i'�L �,r O.LL.l�Z <br />State License Number <br />�r S �c L-:s <br />Proposed Use of Building <br />Descnption of Work to Be Done: 5 e rv� �; G�.••.� <br />NOTE: WIRING IN NON-DWELLINGS IS REQUIRED TO <br />BE IN RACEWAYS, MC OR AC CABLE. <br />CITI' OF EVERETT LOCAL SALES TAX CODE IS 3105 <br />Contract Price of Work <br />Contact Person (Plan Review) <br />1 hereby certif�- Ihaf 1 have read and examined fhis appGcafion and know fhe seme to be true and <br />coriecL All provisious ollaws and ordinances goveming Nris type ol wo�k will be completed <br />whether specified herein or noL The �ranfing ol a,�ermd does not presume fo give aulhonty to <br />violate or cancel the provisions ol any ofher state or local law regulafing constn�cfion or fhe <br />pedormance ol construction. That I am aufhonzed by Ihe owner ol this property fo peAortn fhn <br />work (or which applicalion is made and 1 comply wifh the Stafe Contracfors Law 18.27 RCW ond <br />296200 WAC. <br />\' <br />C7 <br />FEE <br />.�a J�J �.� <br />